Insulin, Glucose, and You

When you hear the word insulin, you may think of a drug taken by people who have diabetes.While this is true, what you may not know is that insulin is one of the many hormones created in the human body.Insulin is important to the body. It allows blood sugar (or glucose) to get into cells to provide them with energy.When you eat, your body breaks down food into glucose in your small intestine.This is your body’s source of energy for everything it does, from working and thinking to exercising and healing.Glucose travels through your bloodstream, looking for individual cells that need energy.For glucose to get into the cells, it requires insulin.Insulin is the key that unlocks cells for glucose to enter and deliver energy.When insulin arrives, it signals the cells to activate glucose transporters.These transporters pull glucose through cell walls.When glucose moves into the cell, it delivers energy.

Insulin deficiency

Insulin is normally produced in the pancreas by specialized cells called beta cells.
When glucose enters your bloodstream, the pancreas matches it with the right amount of insulin to move glucose into your cells.
In people with diabetes, this process doesn't work as it should. In type 1 diabetes, scientists believe the body's immune system mistakenly attacks and destroys beta cells in the pancreas. A person with type 1 diabetes loses the ability to produce insulin.
In type 2 diabetes, the pancreas is not producing enough insulin to meet the body's needs. Over time, the amount of insulin typically becomes less and less.

Insulin resistance

In some type 2 diabetes patients, cells build up a resistance to insulin. Even though there may be insulin in the bloodstream, it is not enough to unlock cells to allow glucose to enter.As a result, it takes more insulin to find the right key to unlock the cell for glucose. This makes it more difficult for cells to get the energy they need.

The effects of diabetes

When glucose can’t get into the cells—either because there isn’t enough insulin or because the body is resisting it—glucose begins to build up in the bloodstream.

As a result, all that energy is wasted. It does not get to cells where it is needed. Without glucose in your cells, they lack the energy they require to keep your body working.

What is Toujeo® (insulin glargine injection) 300 Units/mL?

Prescription Toujeo® is a long-acting insulin used to control blood sugar in adults with diabetes mellitus.

Toujeo® contains 3 times as much insulin in 1 mL as standard insulin (100 Units/mL)

Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Do NOT reuse needles or share insulin pens even if the needle has been changed.

Before starting Toujeo®, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.

Heart failure can occur if you are taking insulin together with pills called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms, including:

Shortness of breath

Sudden weight gain

Swelling of your ankles or feet

Tell your doctor about all the medications you take, including OTC medicines, vitamins, supplements, and herbal supplements.

Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not change your dose or type of insulin without talking to your doctor. Verify that you have the correct insulin before each injection. Do NOT use a syringe to remove Toujeo® from your SoloStar® pen. Your dose for Toujeo® may be different from other insulins you have taken. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Toujeo® with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Use Toujeo® only if the solution is clear and colorless with no particles visible.

While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use medicines that contain alcohol.

The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and life-threatening. Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Toujeo® may cause severe allergic reactions that can lead to death. Get medical help right away if you have:

A rash over your whole body

Shortness of breath

Swelling of your face, tongue, or throat

Extreme drowsiness, dizziness, or confusion

Trouble breathing

Fast heartbeat

Sweating

Toujeo® may have additional side effects including swelling, weight gain, low potassium, and injection site reactions which may include change in fat tissue, skin thickening, redness, swelling, and itching.

Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.

Please see full Prescribing Information for Toujeo® provided with this video.

Toujeo Time

ANNOUNCER: Welcome to Straight Talk About Diabetes, the talk show made FOR people with diabetes—BY people with diabetes.

ERRON: Now in terms of medication, you're on Toujeo®.

AMY: Insulin glargine injection, 300 units per milliliter.

ERRON: For those who may not be familiar, Toujeo is from the makers of Lantus®. It's a long-acting insulin used to control high blood sugar in adults with diabetes. Long-acting insulin is taken once a day. It takes longer to start working in the bloodstream, but it lasts all day long.

AMY: Right.

ERRON: Also, Toujeo contains three times as much insulin in one milliliter as standard insulin, 100 units per milliliter.

[Phone buzzes] Hold on, I got to get this.

[Looks at phone] Hmm.

[Addresses camera] So there are limitations of use for Toujeo that everyone should know. Toujeo is not for use to treat diabetic ketoacidosis. Also, Toujeo should not be used in children. So, Amy, how are you doing since you started on Toujeo?

AMY: My blood sugar levels are normal throughout the day when I measure, and my last A1C was in my target range.

ERRON: Ooh, that's great. I should note that Toujeo is not for everyone, and individual results may vary.

[Phone buzzes] But wait. There's more. This time it's Important Safety Information about Toujeo. Do not take Toujeo if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo.

AMY: Yeah, that's important.

ERRON: Also, do not reuse needles or share insulin pens, even if the needle has been changed. What would you tell somebody who is just getting the news that insulin is the next step for them?

AMY: That don't be afraid. This isn't about, you know, that your disease is so far gone that this is the only thing that's going to help you, that we're able to use that as a tool.

ERRON: That's—I think that's great advice.

AMY: So, yeah.

ERRON: I mean because you hear "insulin" or you hear "medication" period, and you're like—

Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Do NOT reuse needles or share insulin pens even if the needle has been changed.

Before starting Toujeo®, tell your doctor about all your medical conditions,including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.

Heart failure can occur if you are taking insulin together with pills called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms, including:

Shortness of breath

Swelling of your ankles or feet

Sudden weight gain

Tell your doctor about all the medications you take, including OTC medicines,vitamins, supplements, and herbal supplements.

Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not change your dose or type of insulin without talking to your doctor. Verify that you have the correct insulin before each injection. Do NOT use a syringe to remove Toujeo® from your SoloStar®pen. Your dose for Toujeo® may be different from other insulins you have taken. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Toujeo® with any other insulin or solution.It will not work as intended and you may lose blood sugar control, which could be serious.
Use Toujeo® only if the solution is clear and colorless with no particles visible.

While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use medicines that contain alcohol.

The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and life-threatening.Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Toujeo® may cause severe allergic reactions that can lead to death. Get medical help right away if you have:

A rash over your whole body

Shortness of breath

Swelling of your face, tongue, or throat

Extreme drowsiness, dizziness, or confusion

Trouble breathing

Fast heartbeat

Sweating

Toujeo® may have additional side effects including swelling, weight gain, low potassium,and injection site reactions which may include change in fat tissue, skin thickening,redness, swelling, and itching.

Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.

Toujeo Time

ANNOUNCER: Welcome to Straight Talk About Diabetes, the talk show made FOR people with diabetes—BY people with diabetes.

ERRON: Now in terms of medication, you're on Toujeo®.

AMY: Insulin glargine injection, 300 units per milliliter.

ERRON: For those who may not be familiar, Toujeo is from the makers of Lantus®. It's a long-acting insulin used to control high blood sugar in adults with diabetes. Long-acting insulin is taken once a day. It takes longer to start working in the bloodstream, but it lasts all day long.

AMY: Right.

ERRON: Also, Toujeo contains three times as much insulin in one milliliter as standard insulin, 100 units per milliliter.

[Phone buzzes] Hold on, I got to get this.

[Looks at phone] Hmm.

[Addresses camera] So there are limitations of use for Toujeo that everyone should know. Toujeo is not for use to treat diabetic ketoacidosis. Also, Toujeo should not be used in children. So, Amy, how are you doing since you started on Toujeo?

AMY: My blood sugar levels are normal throughout the day when I measure, and my last A1C was in my target range.

ERRON: Ooh, that's great. I should note that Toujeo is not for everyone, and individual results may vary.

[Phone buzzes] But wait. There's more. This time it's Important Safety Information about Toujeo. Do not take Toujeo if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo.

AMY: Yeah, that's important.

ERRON: Also, do not reuse needles or share insulin pens, even if the needle has been changed. What would you tell somebody who is just getting the news that insulin is the next step for them?

AMY: That don't be afraid. This isn't about, you know, that your disease is so far gone that this is the only thing that's going to help you, that we're able to use that as a tool.

ERRON: That's—I think that's great advice.

AMY: So, yeah.

ERRON: I mean because you hear "insulin" or you hear "medication" period, and you're like—

Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Do NOT reuse needles or share insulin pens even if the needle has been changed.

Before starting Toujeo®, tell your doctor about all your medical conditions,including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.

Heart failure can occur if you are taking insulin together with pills called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms, including:

Shortness of breath

Swelling of your ankles or feet

Sudden weight gain

Tell your doctor about all the medications you take, including OTC medicines,vitamins, supplements, and herbal supplements.

Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not change your dose or type of insulin without talking to your doctor. Verify that you have the correct insulin before each injection. Do NOT use a syringe to remove Toujeo® from your SoloStar®pen. Your dose for Toujeo® may be different from other insulins you have taken. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Toujeo® with any other insulin or solution.It will not work as intended and you may lose blood sugar control, which could be serious.
Use Toujeo® only if the solution is clear and colorless with no particles visible.

While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use medicines that contain alcohol.

The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and life-threatening.Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Toujeo® may cause severe allergic reactions that can lead to death. Get medical help right away if you have:

A rash over your whole body

Shortness of breath

Swelling of your face, tongue, or throat

Extreme drowsiness, dizziness, or confusion

Trouble breathing

Fast heartbeat

Sweating

Toujeo® may have additional side effects including swelling, weight gain, low potassium,and injection site reactions which may include change in fat tissue, skin thickening,redness, swelling, and itching.

Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.

Meet Bill

Bill: You know I find that humor makes people feel better. As someone who’s had type 2 diabetes for almost 20 years, I find it helps me get through some pretty rough spots.

SUPER: BILL HAS TYPE 2 DIABETES. THIS IS HIS STORY.

Bill: I guess you could say humor comes naturally to me. I remember as a kid I thought I could be pretty funny.

Bill: I even did a stand-up act years ago in the late ‘80s, played comedy clubs all around the country. I couldn’t help it—I was always writing jokes, or finding the humor in things.

Bill: Comedy was fun, but then I thought it was time to settle down.

Bill: I work as a project manager now, but I still love to see people smiling and laughing.

Bill: I dress up like Santa at Christmastime for the kids at the local hospitals. With this beard, I’m pretty convincing. (chuckle) It’s fun for the kids, and it’s good for me to see them happy.

Bill: When I was first diagnosed with diabetes, it definitely changed how I went about my life.

Bill: For a while, I managed diabetes with medications. My family is very supportive. My wife, Tish, gives me endless encouragement and support. She has a good sense of humor, too, and she lightens up my day.

Bill: Then I went through a period where, I admit, I wasn’t doing that whole due diligence thing, wasn’t on top of it.

Bill: I didn’t eat right,

Bill: I didn’t exercise much.

Bill: After a long day at my office and commuting, I didn’t have the energy to work out. Plus, I wasn’t testing my blood sugar levels every day.

Bill: But I’ve never been one to quit. I’m just not that guy. It’s like someone flipped a switch. I said to myself…

Bill: “Bill, you gotta stop ignoring the obvious. This diabetes thing isn’t going to go away. Get with the program, do whatever you got to do to keep it in check.”

Bill: So I talked about it with my doctor, and told her about how my diabetes management was going. She explained that diabetes can change over time, and that the ways you manage it may have to as well. That’s when we decided that Toujeo® (insulin glargine injection) 300 Units/mL was an option for me.

Voiceover: From the makers of Lantus® (insulin glargine injection) 100 Units/mL comes Toujeo® (insulin glargine injection) 300 Units/mL. Toujeo® is a long-acting, man- made insulin used to control high blood sugar in adults with diabetes. Toujeo® contains 3 times as much insulin in 1 mL as standard insulin (100 Units/mL). Toujeo® is not for use to treat diabetic ketoacidosis. Toujeo® should not be used in children.

Voiceover: Do not use Toujeo if you are having an episode of low blood sugar or have an allergy to insulin glargine or any of the ingredients in Toujeo®.

Bill: I take Toujeo® once a day at the same time every day.

Bill: Toujeo® works by slowly releasing small amounts of insulin to provide continuous glucose-lowering activity that lasts beyond 24 hours.

Voiceover: The most common side effect of any insulin, including Toujeo® is low blood sugar (hypoglycemia), which may be serious and life-threatening. Don’t share needles or insulin pens with others, even if the needle has been changed. Don’t reuse needles.

What is Toujeo® (insulin glargine injection) 300 Units/mL?
Prescription Toujeo® is a long-acting insulin used to control blood sugar in adults with diabetes mellitus.

Toujeo® contains 3 times as much insulin in 1 mL as standard insulin (100 Units/mL)

Toujeo® is not for use to treat diabetic ketoacidosis

Toujeo® should not be used in children

Important Safety Information for Toujeo® (insulin glargine injection) 300 Units/mL
Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Do NOT reuse needles or share insulin pens even if the needle has been changed.

Before starting Toujeo®, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.

Heart failure can occur if you are taking insulin together with pills called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo® . Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms, including:

Shortness of breath

Sudden weight gain

Swelling of your ankles or feet

Tell your doctor about all the medications you take, including OTC medicines, vitamins, supplements, and herbal supplements.

Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not change your dose or type of insulin without talking to your doctor. Verify that you have the correct insulin before each injection. Do NOT use a syringe to remove Toujeo® from your SoloStar® pen. Your dose for Toujeo® may be different from other insulins you have taken. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Toujeo® with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Use Toujeo® only if the solution is clear and colorless with no particles visible.

While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use medicines that contain alcohol.

The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and life-threatening. Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Toujeo® may cause severe allergic reactions that can lead to death. Get medical help right away if you have:

A rash over your whole body

Shortness of breath

Swelling of your face, tongue, or throat

Extreme drowsiness, dizziness, or confusion

Trouble breathing

Fast heartbeat

Sweating

Toujeo® may have additional side effects including swelling, weight gain, low potassium, and injection site reactions which may include change in fat tissue, skin thickening, redness, swelling, and itching.

Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.

Please see full Prescribing Information for Toujeo® provided with this video.

Douglas: My goals are to be healthy, and to make sure I’m doing my best to manage my diabetes. My diabetes has changed over time, and I wonder if the way I manage it needs to as well. I’m ready to talk to my doctor, and learn about my options.

SUPER: Vanessa. Diabetes Educator

Vanessa: One option is Toujeo® (insulin glargine injection) 300 Units/mL. Toujeo® is a long-acting man-made insulin used to control high blood sugar in adults with diabetes mellitus.

SUPERS:

Toujeo® is a long-acting man-made insulin used to control high blood sugar in adults with diabetes mellitus.

Toujeo® contains 3 times as much insulin in 1 mL as standard insulin (100 U/mL)

Toujeo® is not for use to treat diabetic ketoacidosis

Toujeo® should not be used in children

Please see Full Important Safety Information and link to Full Prescribing Information for Toujeo® below.

Vanessa: Do not take Toujeo® during episodes of low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

SUPER: Do not take Toujeo® during episodes of low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Vanessa: Toujeo® works by slowly releasing small amounts of insulin to provide continuous glucose-lowering activity that lasts beyond 24 hours.

SUPERS:

The Toujeo® glucose lowering activity is different than the equivalent dose of Lantus® (insulin glargine injection) 100 Units/mL

Once-daily Toujeo® should be taken once a day at the same time each day

Vanessa: The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and life threatening.

SUPERS:

Most common side effect:

Low blood sugar (hypoglycemia)

May be serious and life-threatening

Don't share needles, insulin pens, or syringes with others, even if the needle has been changed. Don’t reuse needles.

Please see full Important Safety Information for Toujeo® below.

What is Toujeo® (insulin glargine injection) 300 Units/mL?
Prescription Toujeo® is a long-acting insulin used to control blood sugar in adults with diabetes mellitus.

Toujeo® contains 3 times as much insulin in 1 mL as standard insulin (100 Units/mL)

Toujeo® is not for use to treat diabetic ketoacidosis

Toujeo® should not be used in children

Important Safety Information for Toujeo® (insulin glargine injection) 300 Units/mL
Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Do NOT reuse needles or share insulin pens even if the needle has been changed.

Before starting Toujeo®, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.

Heart failure can occur if you are taking insulin together with pills called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms, including:

Shortness of breath

Sudden weight gain

Swelling of your ankles or feet

Tell your doctor about all the medications you take, including OTC medicines, vitamins, supplements, and herbal supplements.

Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not change your dose or type of insulin without talking to your doctor. Verify that you have the correct insulin before each injection. Do NOT use a syringe to remove Toujeo® from your SoloStar® pen. Your dose for Toujeo® may be different from other insulins you have taken. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Toujeo® with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Use Toujeo® only if the solution is clear and colorless with no particles visible.

While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use medicines that contain alcohol.

The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and life-threatening. Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Toujeo® may cause severe allergic reactions that can lead to death. Get medical help right away if you have:

A rash over your whole body

Shortness of breath

Swelling of your face, tongue, or throat

Extreme drowsiness, dizziness, or confusion

Trouble breathing

Fast heartbeat

Sweating

Toujeo® may have additional side effects including swelling, weight gain, low potassium, and injection site reactions which may include change in fat tissue, skin thickening, redness, swelling, and itching.

Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.

Please see full Prescribing Information for Toujeo® provided with this video.

AMY: Mm-hmm. So for quite some time my diabetes was changing, but I didn't know.

ERRON: Okay.

AMY: So when I went back to see the doctor, and I go in and we have the conversation where, "You're going to have to take insulin."

ERRON: Gotcha.

AMY: I took it very negatively, and, and, again, you know, you've got to remember I'm still in a place of fear. Right? So now one of my worst fears is
coming true, and that is, wow, I must be really bad if I have to take insulin. Okay?Because only the really bad ones take insulin. Right? I mean that was my misperception.

ERRON: Right.

AMY: But it was still my perception. So that kind of flared my, my, um, my denial again, because, because, again, the whole denial, you know, my denial was all based on fear.

ERRON: Yeah.

AMY: And I'm a thinker. So it was like, you know, this is really what's going to help, and then, of course, the lizard side of my brain takes over and is like, "But I
have to—it's a shot!”

ERRON: Right.

AMY: “It's going to hurt." Right? So, okay. I'm a nurse. Right?

ERRON: Right.

AMY: I can give shots to everyone. I can give shots to—yeah, not a problem. I can give shots without a problem. But giving it to yourself?

ERRON: That can be a big one.

AMY: That's a whole other story. So finally, finally, finally, I, I put the needle on, I prepped the pen. I kind of took a big, deep breath, and boom, I did it. It was kind of like [sings], I did it!

ERRON: Achievement unlocked.

AMY: Yes. The, the key to that whole thing—

ERRON: Mm-hmm.

AMY: —was, six months after I had started it, when I went back to the doctor,and she checked my A1C and she looked at my glucose logs, and we saw
progress.

ERRON: Okay.

AMY: And it's like, wow! I can do this!

ERRON: So you just had to rip the Band-Aid off.

AMY: I did. I did, and it was—

ERRON: You just had to do it.

AMY: Yeah, and of course it wasn't a fast pull. Right?

ERRON: Right.

AMY: You know, it took me a while.

ERRON: It takes a little bit longer.

AMY: So it was like, eek, eek, eek, yeah. So then it was kind of like, okay, okay, I think I got this. Okay, I think I got this.

KATHY: Today, we’re going to show you how to use and store your Toujeo® SoloStar® pen.

Learning how to properly use your Toujeo® SoloStar® pen can help get you off to a good start on your Toujeo® treatment.

Prescription Toujeo® is a long-acting insulin used to control blood sugar in adults with diabetes mellitus.

Toujeo® contains 3 times as much insulin in 1 milliliter as standard insulin (100 Units per milliliter)

Toujeo® is not for use to treat diabetic ketoacidosis

Toujeo® should not be used in children

GAIL: Before we start, let’s take a look at the pen. I’ve been using the Toujeo® SoloStar® pen for some time now, and it has features that I really like.

It uses a small, thin needle...

...It has push-button injection, with a hold time of only 5 seconds...

...plus, the dosing window is large, and clearly displays the dosage amount. It helps me check that I’ve dialed in my correct dose.

KATHY: Remember, don’t share needles or insulin pens with others, even if the needle has been changed. And don’t reuse needles.

In this video, Gail and I will be taking you through each of the 6 steps for using your Toujeo® SoloStar® pen:

Checking your pen

Attaching a new needle

Performing a safety test

Selecting the dose

Injecting your dose

And removing the needle

Remember to talk with your healthcare provider about how to inject before you begin using your pen. Review all of the instructions before using your pen. If you do not follow all of these instructions, you may get too much or too little insulin.

Step 1: Check your pen

GAIL: If you’re going to be using a new Toujeo® SoloStar® pen, take it out of the refrigerator at least 1 hour before use to let it warm up. I’ve found that cold insulin can be painful to inject.

Before I begin, I always make sure that I have the correct insulin by checking the name of the insulin on the label of my pen. If you use other injector pens, it is especially important to confirm you have the correct medicine.

KATHY: Also, check the label for the expiration date. Do not use your pen if it’s after the expiration date.

GAIL: First, make sure your hands are clean, and then pull off the pen cap. Take a look at the insulin inside the pen to see if it is clear.

KATHY: Don’t use the pen if the insulin looks cloudy, colored, or contains particles. If you see any of these, use a new pen.

GAIL: Next, wipe the rubber seal at the end of the pen with an alcohol swab. Now you are ready for the next step.

KATHY: Step 2: Attach a new needle

There are a few things to remember before we show you how to attach the needle. Do NOT reuse needles. Be sure to always use a new, sterile needle for each injection. This helps stop blocked needles, contamination, and infection.

Always use needles from BD (such as BD Ultra-Fine®), Ypsomed (such as Clickfine®) or Owen Mumford (such as Unifine® Pentips®).

GAIL: First, take a new needle and peel off the protective seal.

Hold the needle so it’s straight, and then screw it onto the pen. Be careful not to overtighten it.

Next, pull off the outer needle cap and put it to the side—you’ll need it after you have finished injecting.

Then pull off the inner needle cap and throw it away.

KATHY: Remember to be careful when you’re handling needles. You want to avoid injuring yourself with the needle, and also make sure that the needle stays sterile.

Step 3: Perform a safety test

Always do a safety test before each injection to make sure your pen and needle are working properly. This can help to make sure that you get the correct insulin dose.

GAIL: To begin, select 3 units by turning the dose selector until the dose pointer is at the mark between 2 and 4.

Then press the injection button all the way in. When insulin comes out of the needle tip, you know that the pen is working correctly.

If no insulin appears, you may need to repeat this step up to 3 times before seeing insulin.

KATHY: If no insulin comes out after the third time, the needle may be blocked. If this happens, simply change the needle and repeat the safety test.

If you have repeated the safety test with a new needle, but there still is no insulin coming out of the needle tip, do not use the pen. Use a new one.

Here are some other things to remember as you prepare for your injection. Do not use a syringe to remove insulin from your pen.

Also, you may see air bubbles in the insulin. This is normal; they will not harm you.

Step 4: Select the dose

GAIL: Your Toujeo® SoloStar® pen contains a total of 450 units of insulin.

You can select doses from 1 to 80 units in steps of 1 unit. Each pen contains more than 1 dose. You can see roughly how many units of insulin are left by looking at where the plunger is on the insulin scale.

Ask for help if you have any problems handling the pen, for example if you have problems with your eyesight.

KATHY: Before selecting a dose, first make sure there is a needle attached and the dose is set to 0. Do not select a dose or press the injection button without a needle attached. This may damage the pen.

GAIL: The dose window shows the amount of units selected. Even numbers are shown in line with the dose pointer. Odd numbers are shown as a line between even numbers.

To select your dose, turn the dose selector until the dose pointer lines up with your dose. If you turn past your dose, you can turn it back.

If there aren’t enough units in your pen to get your full dose, the dose selector will stop at the number of units left. If you can’t select your full prescribed dose, you can split the dose between two pens. Or, simply use a new pen.

KATHY: Step 5: Inject your dose

Toujeo® can be injected in three areas of your body.

Anywhere in your stomach area, except for a two-inch radius around the navel...

...in the fatty tissue on the outer back area of your upper arm...

...or in your thighs. Avoid injecting too close to the bony area above your knees.

Remember, the injection site should be changed each time you inject.

Here are a few other guidelines you should follow when you inject.

Do not inject your insulin into a vein...

...rotate your injection sites as instructed by your doctor...

...never reuse needles...

...do not use your pen if it is damaged or not working properly, and if you find it hard to press the injection button in, do not force it as this may break your pen.

GAIL: Once you’ve chosen an injection site, wipe the injection site with an alcohol swab. Then, push the needle into your skin as shown by your healthcare provider. Do not touch the injection button yet.

Next, place your thumb on the injection button, then press all the way in and hold. Don’t press at an angle, or your thumb could block the dose selector from turning.

Keep the injection button held in, and when you see “0” in the dose window, slowly count to 5. This will make sure you get your full dose.

After holding and slowly counting to 5, release the injection button. Then remove the needle from your skin.

KATHY: If you find it hard to press the button in, change the needle and then do a safety test like we showed you earlier in this video. If you still find it hard to press in, get a new pen. Do not use a syringe to remove insulin from your pen.

Step 6: How to remove and dispose of used needles, and then store your Toujeo® SoloStar® pen for future use.

After you’ve injected your dose, it’s time to remove the needle. Remember to take care when handling needles to prevent needle injury and cross-infection. Also, do not put the inner needle cap back on.

GAIL: To remove the needle, first grip the widest part of the outer needle cap. Keep the needle straight and guide it into the outer needle cap. Then push the cap firmly on. Be careful; the needle can puncture the cap if you guide it in at an angle.

Next, grip and squeeze the widest part of the outer needle cap, and then turn the pen several times with your other hand to remove the needle. If the needle does not come off at first, try again.

Once the needle is off, throw it away in a sharps puncture-resistant container. Be sure to only dispose of used needles in this type of container.

Your Sharps container can also be used to dispose of your pen when it is time to discard it.

For more information on the right containers you should use, visit www dot safe needle disposal dot org.

Finally, put the pen cap back on, but do not put the pen back in the refrigerator. We’ll go over how to store the pen next.

This completes the 6 steps to injecting and using the Toujeo® SoloStar® pen.

KATHY: Please refer to the Toujeo® Instructions for Use provided with your pen, if you have questions.

Finally, let’s talk about how to store your SoloStar® pen.

An opened Toujeo® SoloStar® pen should be stored at room temperature below 86 degrees Fahrenheit (30 degrees Celsius). Do not refrigerate an opened SoloStar® pen.

Keep out of direct heat and light.

Do not store your pen with the needle attached.

Store your pen with the pen cap on.

Discard 42 days after first use even if the pen still contains insulin.

An unopened Toujeo® SoloStar® pen should be stored in the refrigerator with the pen cap on at a temperature between 36 degrees Fahrenheit and 46 degrees Fahrenheit (2 degrees Celsius and 8 degrees Celsius) in the box it came in. Do not freeze new pens. Discard pens after the expiration date.

GAIL: Thanks for joining Kathy and I as we walked through how to use the Toujeo® SoloStar® pen. We hope that you found these instructions helpful.

KATHY: If you have any further questions about the Toujeo® SoloStar® pen or managing your diabetes, speak to your doctor, nurse, or pharmacist.

We will now present the full Important Safety Information for Toujeo®.

What is Toujeo® (insulin glargine injection) 300 Units/mL?

Prescription Toujeo® is a long-acting insulin used to control blood sugar in adults with diabetes mellitus.

Toujeo® contains 3 times as much insulin in 1 mL as standard insulin (100 Units/mL)

Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Do NOT reuse needles or share insulin pens even if the needle has been changed.

Before starting Toujeo®, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.

Heart failure can occur if you are taking insulin together with pills called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms, including:

Shortness of breath

Sudden weight gain

Swelling of your ankles or feet

Tell your doctor about all the medications you take, including OTC medicines, vitamins, supplements, and herbal supplements.

Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not change your dose or type of insulin without talking to your doctor. Verify that you have the correct insulin before each injection. Do NOT use a syringe to remove Toujeo® from your SoloStar® pen. Your dose for Toujeo® may be different from other insulins you have taken. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Toujeo® with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Use Toujeo® only if the solution is clear and colorless with no particles visible.

While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use medicines that contain alcohol.

The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and life-threatening. Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Toujeo® may cause severe allergic reactions that can lead to death. Get medical help right away if you have:

A rash over your whole body

Shortness of breath

Swelling of your face, tongue, or throat

Extreme drowsiness, dizziness, or confusion

Trouble breathing

Fast heartbeat

Sweating

Toujeo® may have additional side effects including swelling, weight gain, low potassium, and injection site reactions which may include change in fat tissue, skin thickening, redness, swelling, and itching.

Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.

Please see full Prescribing Information for Toujeo® provided at the link below.

AMY: It does. And for me it takes away my confidence that yes, indeed, I made a healthy choice. So I have learned kind of a little…I have come up with a couple little smart remarks that I will make to people. Believe me, the more technical that you make it, the more they want you to shut up and go away and get off the elevator, so I try to make it very, “Well, this is 27 carbohydrates and this is gonna match with this.” It works.

AMY: It’s just like, “Oh, cake…” So, one of the things that’s really helped me is, um, my glucose meter. I use it like my GPS.

ERRON: Okay.

AMY: So if I am really jonesing for a piece of cake, the best thing that I can do is check my blood sugar. And if it’s not, you know, where I want it to be, then I can’t choose that right now.

ERRON: Right.

AMY: But I’ll talk to myself and say, “Okay now, if I can make good, healthy choices for dinner and I have a nice, healthy breakfast tomorrow, maybe I can have my cake tomorrow!”

ERRON: Right.

Amy: So I have learned how to make better choices.

ERRON: Okay.

AMY: I can actually say no, Erron.

ERRON: So if I brought in a yellow cake—

AMY: I could say no.

ERRON: —with some chocolate icing—

AMY: I could say no.

ERRON: —from your favorite bakery—

AMY: I could say no.

ERRON: —right now?

AMY: I could say no.

ERRON: With a nice, frosty glass of milk?

AMY: I know. La, la, la, I could say no.

ERRON: All right. Bring the cake—I’m just playing. So, tell me about exercise, what’s your regimen? What do you do?

AMY: For me it’s the E word. I just am not a big fan. But I have a friend of mine that we’re kind of in the same boat.

ERRON: Somebody you work with, a coworker?

AMY: We used to work together and we became best friends, and now we don’t work at the same place anymore, but through the magic of text messaging…

ERRON: “Hey BFF, what you doing?”

AMY:Exactly! There were a couple of times when, um, I was able to get a little bit of a break and so did she, and we were both taking a walk at the same time, but we were two cities away from each other. You know, my kids are home a little bit more, um, they are doing a lot more to say, “Mom, let’s get out and take this walk” or “Let’s go here and let’s do this.”

ERRON: Right.

AMY: So that way, they’re kind of helping me to get out and do stuff like that, ‘cause I have to be accountable to somebody or it’s not going to happen.

ERRON: You know, is, is there any stress around surrounded with not necessarily being able to enjoy that cookie like that you really want to, or, or—

AMY: Absolutely.

ERRON: —a number of those cookies?

AMY: Absolutely. Um, it can be really stressful, and of course the food police really comes out at holiday time.

ERRON: Oh yeah, they do.

AMY: Oh, don't they? They come out of the woodwork. Right? "Are you supposed to be eating that?" [Sighs] That alone is stressful. That alone is stressful. And also I, I do kind of lose a little bit of my confidence around the holidays, and I think it's because, you know, your normal routine is kind of thrown out the window.

But I, I try to get, kind of get back to it, kind of think about it ahead of time,knowing that, you know, okay, we're going to go here, and this is kind of what the spread is going to look like. And I'm expecting that these kind of foods are going to be there, and there are going to be some yummy trigger foods. You know, my,my little peanut butter blossoms are going to be there. So it's kind of leading up to that, I try to really stick to things, really try to focus on, you know, making healthy choices, maybe even make healthier choices than maybe I normally would, just so that that way when I get there and I am kind of faced with that spread, it's kind of like, okay, I, I can handle this.

ERRON: Yeah.

AMY: And you learn some tricks. You know, there a couple things that I learned about going to holiday parties.

ERRON: Mm-hmm.

AMY: The first thing I learned is always—

ERRON: Tell me, because I need to know.

AMY: —always have a cup with water or your beverage of choice, you know,your low-calorie beverage of choice in there has really been helpful for me,
because then you don't have the host coming up to you all the time trying to refill your drink.

ERRON: Oh, that's sneaky. Okay. Give me another one.

AMY: The other thing, too, is, um, small plates.

ERRON: Okay.

AMY: Because if you, if you, if you kind of fill up a small plate, that's still not nearly as much food as what's on a big plate.

ERRON: Right.

AMY: And, you know, and I always try to make sure that when I go to a holiday party—like the last time I went there were all these crazy, you know, super-highcalorie crazy party food. And I brought something that I had made that I knew what was in it. So I knew it was kind of safe, for lack of a better word.

ERRON: Right.

AMY: So I made sure that I had, you know, I had a small plate. I had, you know,my veggies and my hummus, which is my favorite thing.

ERRON: Mm-hmm.

AMY: Um, especially at parties, and then I would have some of, you know, the little casserole that I had brought, that I knew was fairly safe. So that way, again,when the host kind of comes around to check on you, "Hey, how ya' doing?” “Have you tried this?" You're like, "Oh, oh, everything is just delicious. Everything is just great."/p>

ERRON: Right.

AMY: And that way you don't feel like, you don't feel nearly as much pressure,because they're not giving it to you.

Meet Erron Jay

ANNOUNCER: Welcome to Straight Talk About Diabetes, the talk show made FOR people with diabetes—BY people with diabetes.

ERRON: Hello, hello, hello, everyone. I'm Erron Jay, and I'll be your host for this series of one-on-one conversations with people just like you and me who duke it out daily with the dia-burden of diabetes, just me and a friend telling our truths about what we dia-do and dia-don't. I've been living with type 2 diabetes for 15 years. Like so many of us, when I got diagnosed I thought the party was over.

I remember looking up a few of the symptoms I noticed online: thirst, fatigue,frequent urination, and it said for me I could have either had diabetes, a urinary tract infection, or something else. And, you know, you've never seen a grown man pray so hard for a urinary tract infection in your life. But sure enough, after talking with my doctor it was clear; I had diabetes.

Current statistics say that one in ten Americans have diabetes. The problem is,for a disease this common, it doesn't seem like people are talking enough about what it's actually like to live with it. So we're here to change that.

We're going to cover all the angles, like food. In my case, I had to say goodbye to my regular cake sessions. If I'm being real with you all, cake meant more to me than my own dog—and I love my dog. Cake has always been my jam. Cake with jam is also my jam.

But now if I want a single slice, my doctor says I need to up my exercise and check my blood glucose, and it means no cake for me tomorrow. I've slapped my own wrist in public. Ha, no cake for you, Erron. Did strangers look at me like I had lost my mind? Maybe. Did not eating the cake help stop my blood sugar from spiking? Darn right it did.

You see, it's all about finding balance. We're here to share our experiences, tips,tricks, and life hacks so we can all feel less alone and hopefully make better decisions along the way. So, let's get started.

Our first guest is a diabetes diva from Dayton, Ohio. Here's Amy. Amy!

Amy: And you know what they say about nurses being such great patients.

ERRON: Yeah, like Nurse Ratched.

AMY: True. Oh, no, no, no, no, no, no. No, no, no, no, no. I'm nice.

ERRON: Oh, that's what you say now.

AMY: Well, true.

ERRON: For all our friends that are out there, that are watching us talk about this and getting real with it, how important is that support system for you to keep you, you know, moving along?

AMY: Well, in addition to the four lovely people that live in my house, um, there are also my dad, my sister and her family, and they have actually been the most supportive in helping me to get from out of control to under control. And now that I've been working a little bit harder, and they've been seeing the results of what I'm trying to do, and they're understanding what it is, you know, why I need to take a break to do this, why it's time for me to just take a break and check my blood sugar, and do make a choice based on the result of that blood sugar. Now that they understand that, it's extremely supportive. So they have been really wonderful.

ERRON: So before this were, um—

AMY: They were not.

ERRON: Did they—well, did they see you like—were you—did they think you were using it as a crutch? Is that what it was?

AMY: Oh no, no. My friend, Erron, I was the queen of denial.

ERRON: Oh.

AMY: I had the biggest crown and the most jewels that there were possible.

ERRON: Your highness.

AMY: Oh, absolutely. So I really wasn't doing what I needed to do to take care of myself. And so because I wasn't doing that, because I wasn't focusing on it, because I was pretending it wasn't there, then they didn't think it even existed. So they didn't even know what to do.

ERRON: So what were you in denial about?

AMY: Oh, Erron, it was everything. It was, um, first of all that there was something wrong with me, second of all, that there were things that I needed to do to take care of myself. I went to the doctor's office. The doctor would say, um, "You need to lose weight. You need to eat healthy," and then I would go home and do nothing. You know, I really made no changes to my diet. I was not doing anything, anything in the real—in the realm of exercise. And checking my blood sugar? Ha, ha. No. Um, they had
prescribed one pill for me. I mean it shouldn't have been hard. Right? I mean it was one pill one day, you know, once a day. How hard can that be? I would continually forget to
take it. And then I would go back and I would have to go see the doctor, and it would get worse and worse each time until finally it was, why are you not doing this?

ERRON: Your doctor had to get real with diabetes.

AMY: Oh. She, she finally got really, um—I wouldn't say it was angry, ‘cause she, ‘cause she wasn't, you know, like [makes growling sound], but she really let me have it. She really did get real with me and said, "Listen. You have this problem."

ERRON: Now was it negative or that's how you perceived it?

AMY: I'm sure I probably did think I was being spanked.

ERRON: Because she sounds like she's pretty awesome.

AMY: Well, you're right, she is awesome, but don't tell her that.

ERRON: Okay.

AMY: Okay.

ERRON: On the hush.

AMY: Shh, shh, shh, shh. But I was starting to have symptoms. I was starting to have some complications. The biggest one was fatigue. I was so tired all the time. I would find myself, I would sit down in a chair and I would go to sleep.

ERRON: Right.

AMY: So it took, it really took my dad, who kind of came to me and said, "You know what? I'm really worried about you." And, of course, I'm like, "What are you talking about?"

ERRON: Right. "I'm good."

AMY: You know, "I am fine." But, um, but then we had a really great conversation, and it had happened, you know, after we had lost my mom, and basically it was, you know, "I'm worried about you."

ERRON: Okay.

AMY: So I think a lot of the reason why I went into denial was because I was so overwhelmed at all the things I had to do.

ERRON: Mm-hmm.

AMY: And the biggest thing was that I had to make changes to my lifestyle, and that's scary.

ERRON: Gotcha.

AMY: But again, having that conversation with him was, I think, one of the things that really helped me to kind of open the door, you know, like I said, open the door to allow people in to help me, and for me, again, to take some of those first steps toward getting myself under control.

Baby Steps

ANNOUNCER: Welcome to Straight Talk About Diabetes, the talk show made FOR people with diabetes—BY people with diabetes.

ERRON: Was there something that just snapped Amy out of her denial, and you were like, "I am going to live this type of lifestyle. I'm going to make these changes," and how do you feel now because you made that decision?

AMY: It was about four and a half years ago, and I was taking baby steps. I had started with taking my medicine and checking my blood sugar. That was my priority, with one pill that was once a day.

ERRON: Okay.

AMY: And then I started to kind of add in some of the other things. So I started to, um,walk a little bit more.

ERRON: Okay.

AMY: But the really key part was when I went back to the doctor, and she checked my A1C, and she lost her mind.

ERRON: (Chuckling)

AMY: She took me to the other partners in the practice and said, "You are not going to believe this." I got hugs, I got high fives, I got fist bumps from the other three doctors in the practice. I'm a different person now, because I figured out I could take care of myself.

ERRON: Like you said, if you don't take care of yourself, who's going to do it?

AMY: Right?

ERRON: Yeah. If you had—to keep it real.

AMY: Yeah?

ERRON: I mean real—

AMY: Oh, really real?

ERRON: I mean all the way real.

AMY: All right.

ERRON: I mean for real, for real.

AMY: Okay.

ERRON: That's what, that's when you know it's serious, when you say it twice in a row.

BOTH: For real, for real.

ERRON: Yeah. What would you tell somebody getting their, their diagnosis right now?And they're feeling like the world is collapsing around them. What would you tell them?

AMY: We need to break it down.

ERRON: Okay.

AMY: You know, when you go to the doctor.

ERRON: Mm-hmm.

AMY: Especially that first time you're diagnosed.

ERRON: All right.

AMY: Um, "You need to lose weight. You need to eat healthy."

ERRON: Your "welcome to diabetes bullet points."

AMY: Yup, and you kind of leave the office and you're like, what just happened? It's taking baby steps. Because, again, I think a lot of the reason why I went into denial was because I was so overwhelmed at all the things I had to do. So the first thing that I focused on was checking my blood sugar and taking my medicine. Let's get a quick win.

ERRON: Gotcha.

AMY: So you just take those little, tiny moments, put them together, and that's what's going to really help, help you be successful.

AMY: It does. And for me it takes away my confidence that yes, indeed, I made a healthy choice. So I have learned kind of a little…I have come up with a couple little smart remarks that I will make to people. Believe me, the more technical that you make it, the more they want you to shut up and go away and get off the elevator, so I try to make it very, “Well, this is 27 carbohydrates and this is gonna match with this.” It works.

AMY: It’s just like, “Oh, cake…” So, one of the things that’s really helped me is, um, my glucose meter. I use it like my GPS.

ERRON: Okay.

AMY: So if I am really jonesing for a piece of cake, the best thing that I can do is check my blood sugar. And if it’s not, you know, where I want it to be, then I can’t choose that right now.

ERRON: Right.

AMY: But I’ll talk to myself and say, “Okay now, if I can make good, healthy choices for dinner and I have a nice, healthy breakfast tomorrow, maybe I can have my cake tomorrow!”

ERRON: Right.

Amy: So I have learned how to make better choices.

ERRON: Okay.

AMY: I can actually say no, Erron.

ERRON: So if I brought in a yellow cake—

AMY: I could say no.

ERRON: —with some chocolate icing—

AMY: I could say no.

ERRON: —from your favorite bakery—

AMY: I could say no.

ERRON: —right now?

AMY: I could say no.

ERRON: With a nice, frosty glass of milk?

AMY: I know. La, la, la, I could say no.

ERRON: All right. Bring the cake—I’m just playing. So, tell me about exercise, what’s your regimen? What do you do?

AMY: For me it’s the E word. I just am not a big fan. But I have a friend of mine that we’re kind of in the same boat.

ERRON: Somebody you work with, a coworker?

AMY: We used to work together and we became best friends, and now we don’t work at the same place anymore, but through the magic of text messaging…

ERRON: “Hey BFF, what you doing?”

AMY:Exactly! There were a couple of times when, um, I was able to get a little bit of a break and so did she, and we were both taking a walk at the same time, but we were two cities away from each other. You know, my kids are home a little bit more, um, they are doing a lot more to say, “Mom, let’s get out and take this walk” or “Let’s go here and let’s do this.”

ERRON: Right.

AMY: So that way, they’re kind of helping me to get out and do stuff like that, ‘cause I have to be accountable to somebody or it’s not going to happen.

ERRON: You know, is, is there any stress around surrounded with not necessarily being able to enjoy that cookie like that you really want to, or, or—

AMY: Absolutely.

ERRON: —a number of those cookies?

AMY: Absolutely. Um, it can be really stressful, and of course the food police really comes out at holiday time.

ERRON: Oh yeah, they do.

AMY: Oh, don't they? They come out of the woodwork. Right? "Are you supposed to be eating that?" [Sighs] That alone is stressful. That alone is stressful. And also I, I do kind of lose a little bit of my confidence around the holidays, and I think it's because, you know, your normal routine is kind of thrown out the window.

But I, I try to get, kind of get back to it, kind of think about it ahead of time,knowing that, you know, okay, we're going to go here, and this is kind of what the spread is going to look like. And I'm expecting that these kind of foods are going to be there, and there are going to be some yummy trigger foods. You know, my,my little peanut butter blossoms are going to be there. So it's kind of leading up to that, I try to really stick to things, really try to focus on, you know, making healthy choices, maybe even make healthier choices than maybe I normally would, just so that that way when I get there and I am kind of faced with that spread, it's kind of like, okay, I, I can handle this.

ERRON: Yeah.

AMY: And you learn some tricks. You know, there a couple things that I learned about going to holiday parties.

ERRON: Mm-hmm.

AMY: The first thing I learned is always—

ERRON: Tell me, because I need to know.

AMY: —always have a cup with water or your beverage of choice, you know,your low-calorie beverage of choice in there has really been helpful for me,
because then you don't have the host coming up to you all the time trying to refill your drink.

ERRON: Oh, that's sneaky. Okay. Give me another one.

AMY: The other thing, too, is, um, small plates.

ERRON: Okay.

AMY: Because if you, if you, if you kind of fill up a small plate, that's still not nearly as much food as what's on a big plate.

ERRON: Right.

AMY: And, you know, and I always try to make sure that when I go to a holiday party—like the last time I went there were all these crazy, you know, super-highcalorie crazy party food. And I brought something that I had made that I knew what was in it. So I knew it was kind of safe, for lack of a better word.

ERRON: Right.

AMY: So I made sure that I had, you know, I had a small plate. I had, you know,my veggies and my hummus, which is my favorite thing.

ERRON: Mm-hmm.

AMY: Um, especially at parties, and then I would have some of, you know, the little casserole that I had brought, that I knew was fairly safe. So that way, again,when the host kind of comes around to check on you, "Hey, how ya' doing?” “Have you tried this?" You're like, "Oh, oh, everything is just delicious. Everything is just great."/p>

ERRON: Right.

AMY: And that way you don't feel like, you don't feel nearly as much pressure,because they're not giving it to you.

AMY: Mm-hmm. So for quite some time my diabetes was changing, but I didn't know.

ERRON: Okay.

AMY: So when I went back to see the doctor, and I go in and we have the conversation where, "You're going to have to take insulin."

ERRON: Gotcha.

AMY: I took it very negatively, and, and, again, you know, you've got to remember I'm still in a place of fear. Right? So now one of my worst fears is
coming true, and that is, wow, I must be really bad if I have to take insulin. Okay?Because only the really bad ones take insulin. Right? I mean that was my misperception.

ERRON: Right.

AMY: But it was still my perception. So that kind of flared my, my, um, my denial again, because, because, again, the whole denial, you know, my denial was all based on fear.

ERRON: Yeah.

AMY: And I'm a thinker. So it was like, you know, this is really what's going to help, and then, of course, the lizard side of my brain takes over and is like, "But I
have to—it's a shot!”

ERRON: Right.

AMY: “It's going to hurt." Right? So, okay. I'm a nurse. Right?

ERRON: Right.

AMY: I can give shots to everyone. I can give shots to—yeah, not a problem. I can give shots without a problem. But giving it to yourself?

ERRON: That can be a big one.

AMY: That's a whole other story. So finally, finally, finally, I, I put the needle on, I prepped the pen. I kind of took a big, deep breath, and boom, I did it. It was kind of like [sings], I did it!

ERRON: Achievement unlocked.

AMY: Yes. The, the key to that whole thing—

ERRON: Mm-hmm.

AMY: —was, six months after I had started it, when I went back to the doctor,and she checked my A1C and she looked at my glucose logs, and we saw
progress.

ERRON: Okay.

AMY: And it's like, wow! I can do this!

ERRON: So you just had to rip the Band-Aid off.

AMY: I did. I did, and it was—

ERRON: You just had to do it.

AMY: Yeah, and of course it wasn't a fast pull. Right?

ERRON: Right.

AMY: You know, it took me a while.

ERRON: It takes a little bit longer.

AMY: So it was like, eek, eek, eek, yeah. So then it was kind of like, okay, okay, I think I got this. Okay, I think I got this.

Toujeo Time

ANNOUNCER: Welcome to Straight Talk About Diabetes, the talk show made FOR people with diabetes—BY people with diabetes.

ERRON: Now in terms of medication, you're on Toujeo®.

AMY: Insulin glargine injection, 300 units per milliliter.

ERRON: For those who may not be familiar, Toujeo is from the makers of Lantus®. It's a long-acting insulin used to control high blood sugar in adults with diabetes. Long-acting insulin is taken once a day. It takes longer to start working in the bloodstream, but it lasts all day long.

AMY: Right.

ERRON: Also, Toujeo contains three times as much insulin in one milliliter as standard insulin, 100 units per milliliter.

[Phone buzzes] Hold on, I got to get this.

[Looks at phone] Hmm.

[Addresses camera] So there are limitations of use for Toujeo that everyone should know. Toujeo is not for use to treat diabetic ketoacidosis. Also, Toujeo should not be used in children. So, Amy, how are you doing since you started on Toujeo?

AMY: My blood sugar levels are normal throughout the day when I measure, and my last A1C was in my target range.

ERRON: Ooh, that's great. I should note that Toujeo is not for everyone, and individual results may vary.

[Phone buzzes] But wait. There's more. This time it's Important Safety Information about Toujeo. Do not take Toujeo if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo.

AMY: Yeah, that's important.

ERRON: Also, do not reuse needles or share insulin pens, even if the needle has been changed. What would you tell somebody who is just getting the news that insulin is the next step for them?

AMY: That don't be afraid. This isn't about, you know, that your disease is so far gone that this is the only thing that's going to help you, that we're able to use that as a tool.

ERRON: That's—I think that's great advice.

AMY: So, yeah.

ERRON: I mean because you hear "insulin" or you hear "medication" period, and you're like—

Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Do NOT reuse needles or share insulin pens even if the needle has been changed.

Before starting Toujeo®, tell your doctor about all your medical conditions,including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.

Heart failure can occur if you are taking insulin together with pills called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms, including:

Shortness of breath

Swelling of your ankles or feet

Sudden weight gain

Tell your doctor about all the medications you take, including OTC medicines,vitamins, supplements, and herbal supplements.

Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not change your dose or type of insulin without talking to your doctor. Verify that you have the correct insulin before each injection. Do NOT use a syringe to remove Toujeo® from your SoloStar®pen. Your dose for Toujeo® may be different from other insulins you have taken. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Toujeo® with any other insulin or solution.It will not work as intended and you may lose blood sugar control, which could be serious.
Use Toujeo® only if the solution is clear and colorless with no particles visible.

While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use medicines that contain alcohol.

The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and life-threatening.Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Toujeo® may cause severe allergic reactions that can lead to death. Get medical help right away if you have:

A rash over your whole body

Shortness of breath

Swelling of your face, tongue, or throat

Extreme drowsiness, dizziness, or confusion

Trouble breathing

Fast heartbeat

Sweating

Toujeo® may have additional side effects including swelling, weight gain, low potassium,and injection site reactions which may include change in fat tissue, skin thickening,redness, swelling, and itching.

Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.

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Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Do NOT reuse needles or share insulin pens even if the needle has been changed.

Before starting Toujeo®, tell your doctor about all your medical conditions, including if you have liver or kidney problems,
if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.

Heart failure can occur if you are taking insulin together with pills called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms, including:

Shortness of breath

Sudden weight gain

Swelling of your ankles or feet

Tell your doctor about all the medications you take, including OTC medicines, vitamins, supplements, and herbal supplements.

Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not change your dose or type of insulin without talking to your doctor. Verify that you have the correct insulin before each injection. Do NOT use a syringe to remove Toujeo® from your SoloStar® pen. Your dose for Toujeo® may be different from other insulins you have taken. Any change of insulin should be made cautiously and only under
medical supervision.

Do NOT dilute or mix Toujeo® with any other insulin or solution. It will not work as intended and you may lose blood sugar control,
which could be serious. Use Toujeo® only if the solution is clear and colorless with no particles visible.

While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use medicines that contain alcohol.

The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and life-threatening. Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Toujeo® may cause severe allergic reactions that can lead to death. Get medical help right away if you have:

A rash over your whole body

Shortness of breath

Swelling of your face, tongue, or throat

Extreme drowsiness, dizziness, or confusion

Trouble breathing

Fast heartbeat

Sweating

Toujeo® may have additional side effects including swelling, weight gain, low potassium, and injection site reactions which may include change in fat tissue, skin thickening, redness, swelling, and itching.

Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.

Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®.

Do NOT reuse needles or share insulin pens even if the needle has been changed.

Before starting Toujeo®, tell your doctor about all your medical conditions, including if you have liver or kidney problems,
if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed.

Heart failure can occur if you are taking insulin together with pills called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms, including:

Shortness of breath

Sudden weight gain

Swelling of your ankles or feet

Tell your doctor about all the medications you take, including OTC medicines, vitamins, supplements, and herbal supplements.

Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not change your dose or type of insulin without talking to your doctor. Verify that you have the correct insulin before each injection. Do NOT use a syringe to remove Toujeo® from your SoloStar® pen. Your dose for Toujeo® may be different from other insulins you have taken. Any change of insulin should be made cautiously and only under
medical supervision.

Do NOT dilute or mix Toujeo® with any other insulin or solution. It will not work as intended and you may lose blood sugar control,
which could be serious. Use Toujeo® only if the solution is clear and colorless with no particles visible.

While using Toujeo®, do not drive or operate heavy machinery until you know how Toujeo® affects you. Don’t drink alcohol or use medicines that contain alcohol.

The most common side effect of any insulin, including Toujeo®, is low blood sugar (hypoglycemia), which may be serious and life-threatening. Severe hypoglycemia may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Toujeo® may cause severe allergic reactions that can lead to death. Get medical help right away if you have:

A rash over your whole body

Shortness of breath

Swelling of your face, tongue, or throat

Extreme drowsiness, dizziness, or confusion

Trouble breathing

Fast heartbeat

Sweating

Toujeo® may have additional side effects including swelling, weight gain, low potassium, and injection site reactions which may include change in fat tissue, skin thickening, redness, swelling, and itching.

Toujeo® SoloStar® is a disposable prefilled insulin pen. Talk to your doctor about proper injection technique and follow instructions in the Instruction Leaflet that comes with the pen.

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experiencing problems with a Sanofi US product, please contact
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The health information contained herein is provided for general educational purposes only. Your healthcare professional is the single best source of information regarding your health. Please consult your healthcare professional if you have any questions about your health or treatment.

a"Certified Diabetes Educator" and "CDE" are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.

*This offer is not valid for prescriptions covered by or submitted for reimbursement under Medicare, Medicaid, VA, DOD, TRICARE, or similar federal or state programs, including any state pharmaceutical programs. Please note: the Federal Employee Health Benefits (FEHB) Program is not a federal or state government health care program for purposes of this savings program. Void where prohibited by law. For the duration of the program, the Savings Card carries maximum savings up to:

$500 per pack for all patients who are enrolled in a commercial insurance plan, whether Toujeo® or Lantus® is covered or not by your insurance

$200 per pack of Toujeo® for patients not enrolled in a commercial insurance plan, or in the FEHB Program

$100 per pack of Lantus® for patients not enrolled in a commercial insurance plan, or in the FEHB Program

This offer is valid for up to 3 packs per prescription. Savings may vary depending on patients’ out-of-pocket costs. Upon registration, patients receive all program details. Sanofi US reserves the right to change the maximum cap amount, rescind, revoke, or amend the program without notice.